Provider Demographics
NPI:1255326245
Name:SOUTHWEST VIRGINIA PHYSICIANS FOR WOMEN
Entity Type:Organization
Organization Name:SOUTHWEST VIRGINIA PHYSICIANS FOR WOMEN
Other - Org Name:ABINGDON OBSTETRICS AND GYNELOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:LAVIGNE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:276-628-4335
Mailing Address - Street 1:277 WHITE ST NE
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24210-2913
Mailing Address - Country:US
Mailing Address - Phone:276-628-4335
Mailing Address - Fax:276-628-3195
Practice Address - Street 1:277 WHITE ST NE
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210-2913
Practice Address - Country:US
Practice Address - Phone:276-628-4335
Practice Address - Fax:276-628-3195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-15
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty